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Am Surg 2019 Mar;85(3):e164-e166

Am Surg 2019 Mar;85(3):e148-e150

Am Surg 2019 Mar;85(3):e135-e136

Medicine (Baltimore) 2019 Apr;98(14):e15035

Department of General Surgery, Tianjin Union Medical Center, Tianjin, China.

Rationale: Ulcerative colitis (UC) is a chronic, nonspecific, inflammatory disease of the colon. Colorectal is the main target organ of UC, while other digestive tract involvement is rare. This report describes 2 rare cases of duodenal mucosa lesions in patients with UC after total colectomy. Read More

J Gastric Cancer 2019 Mar 19;19(1):132-137. Epub 2019 Mar 19.

Department of Surgery, Division of General Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (R.O.C.).

The occurrence of hiatal hernia after total gastrectomy with Roux-en-Y reconstruction is rare. We report the case of a 76-year-old man who presented with dyspnea, vomiting, and fever around 8 days after total gastrectomy with Roux-en-Y reconstruction. Abdominal computed tomography revealed a hiatal hernia containing part of the small intestine in the left thoracic cavity. Read More

J Cancer Res Clin Oncol 2019 Mar 28. Epub 2019 Mar 28.

Department of General Surgery, Zhongshan Hospital, Fudan University, NO. 180 Fenglin Road, Shanghai, 200032, China.

Purpose: Gastrointestinal stromal tumors (GISTs) are typically solid neoplasms with small cystic change detected occasionally but in rare instances may present predominantly as cystic lesions. The histopathologic features and prognoses of cystic GISTs (cGISTs) are poorly understood.

Methods: We herein reviewed 20 cGISTs resected or consulted in our institution from January 1, 2003 to December 31, 2014. Read More

J Clin Exp Hematop 2019 ;59(1):17-21

Diffuse large B cell lymphoma (DLBCL) is classified as an aggressive lymphoma due to its poor prognosis regardless of the treatment. Almost all cases of DLBCL are treated using rituximab-combination chemotherapy, but spontaneous regression without any therapeutic modalities may rarely occur. A 35-year-old man complained of abdominal pain and discomfort. Read More

BMC Gastroenterol 2019 Mar 27;19(1):45. Epub 2019 Mar 27.

Department of Medical Sciences, University of Ferrara, St. Anna Hospital, Via Aldo Moro, 8, 44124, Ferrara, Cona, Italy.

Background: Small bowel adenocarcinoma (SBA) is a rare neoplasm, which can occur in a sporadic form or can be associated with a number of predisposing conditions such as hereditary syndromes and immune-mediated intestinal disorders, e.g. celiac disease (CD). Read More

Med Sci (Basel) 2019 Mar 17;7(3). Epub 2019 Mar 17.

Department of Pulmonary and Critical Care Medicine, Sentara Virginia Beach General Hospital, Virginia Beach, VA 23454, USA.

The latest data from the United States and Europe reveal that rare small intestine cancer is on the rise, with the number of cases having more than doubled over the past 40 years in the developed world. Mortality has grown at a slower pace, thanks to improvements in early diagnosis and treatment, as well as a shift in the etiology of neoplasms affecting the small intestine. Nevertheless, 5-year survival for small intestine adenocarcinomas has lingered at only 35%. Read More

Oncol Lett 2019 Apr 12;17(4):3862-3866. Epub 2019 Feb 12.

3rd Department of Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon Hospital, Athens 12462, Greece.

The present report describes the case of an 81-year-old woman who underwent an emergency explorative laparotomy due to small bowel perforation. Diffuse feculent peritonitis due to perforation of the jejunum was identified. In addition, six distinct tumors of the jejunum in close proximity to the perforation site, as well as two more lesions caudally at the ileum, were identified. Read More

Presse Med 2019 Mar 14;48(3 Pt 2):e125-e145. Epub 2019 Mar 14.

Pancreas Translational & Clinical Research Center, San Raffaele Scientific Institute, Milan, Italy; "Vita-Salute" University, San Raffaele Scientific Institute, Milan, Italy. Electronic address:

The correct diagnosis of a patient presenting with a solid pancreatic mass requires a careful diagnostic work-up, since many differential diagnoses are possible that completely alter the following treatments. In our chapter, we have discussed the clinical approach to the problem in a sort of diagnostic flow-chart. Firstly, we analysed the different potential presentations of a solid pancreatic mass, which can be both asymptomatic or symptomatic, and the differential diagnosis based on the symptoms of presentation. Read More

Langenbecks Arch Surg 2019 Mar 15. Epub 2019 Mar 15.

Department of Pathology, FAU Erlangen-Nürnberg, Erlangen, Germany.

Purpose: Gastrointestinal stromal tumors (GISTs) are the most common soft tissue tumors of the GI tract. Studies have been published reporting additional neoplasms in GIST patients. This study aimed to evaluate possible associations of mutation type, morphology, and clinical aspects of GISTs. Read More

World J Surg Oncol 2019 Mar 14;17(1):49. Epub 2019 Mar 14.

Department of Minimally Invasive Surgery, The Affiliated Hospital of Putian University, 999 Dongzhen East Rd, Putian, 351100, Fujian, China.

Background: To determine the optimal timing of duodenal transection in patients undergoing laparoscopic-assisted total gastrectomy (LATG) in combination with laparoscopic spleen-preserving splenic hilar lymphadenectomy (LSPL) for advanced proximal gastric cancer (APGC).

Methods: One hundred twenty-seven patients with APGC who received LATG with duodenal transection as well as LSPL between January 2017 and July 2018 were retrospectively recruited in this study. According to the different transection timing, the patients were allocated into two groups: a conventional group (CG) who received the duodenal transection prior to the LSPL and an experimental group (EG) who were given LSPL before the duodenum was transected. Read More

Surg Clin North Am 2019 Apr 10;99(2):357-367. Epub 2019 Feb 10.

Department of Surgery, University of Alabama at Birmingham, 1808 7th Avenue South, BDB 607 Birmingham, AL 35233-3411, USA. Electronic address:

Compared with other periampullary tumors, cancers of the ampulla of Vater are rare. These tumors tend to present earlier than their pancreatic and distal bile duct brethren. In addition to the hypothesis that they are also less biologically aggressive, ampullary cancers tend to have better survival than other types of periampullary cancers. Read More

Abdom Radiol (NY) 2019 Feb 26. Epub 2019 Feb 26.

Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.

Although the small intestine accounts for over 90% of the surface area of the alimentary tract, tumors of the small intestine represent less than 5% of all gastrointestinal tract neoplasms. Common small bowel tumors typically are well evaluated with cross-sectional imaging modalities such as CT and MR, but accurate identification and differentiation can be challenging. Differentiating normal bowel from abnormal tumor depends on imaging modality and the particular technique. Read More

Tierarztl Prax Ausg G Grosstiere Nutztiere 2019 Feb 26;47(1):55-59. Epub 2019 Feb 26.

IDEXX Vet Med Labor.

A 2-year-old Arabian horse was presented with severe colic symptoms. During explorative laparotomy, a jejuno-jejunal invagination secondary to a submucosal intestinal mass was detected. The involved jejunal segment was surgically removed and an end-to-end anastomosis was created. Read More

Int J Gynecol Pathol 2019 Feb 21. Epub 2019 Feb 21.

Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK (M.M., W.G.M.).

The distinction between a uterine endometrial stromal nodule (ESN) and low-grade endometrial stromal sarcoma (LGESS) is based on the nature of the interface between the lesion and the surrounding myometrium and the presence or absence of vascular invasion. Most LGESS exhibit widespread irregular myometrial invasion with or without vascular invasion, whereas ESNs are well-circumscribed without vascular invasion. Tavassoli and Norris proposed that minor marginal irregularity (up to 3 protrusions, each <3 mm beyond the main mass) is allowable in an ESN and these criteria have been incorporated into the World Health Organization Classification. Read More

Endocrine 2019 Feb 22. Epub 2019 Feb 22.

Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy.

Purpose: The primary end-point was to evaluate the cure fraction. Secondary end-points were to investigate the time to cure, the excess of death risk, the probability of cure and the factors related to these parameters.

Methods: Retrospective study of an ENETS database regarding patients affected by Si-NENs. Read More

Prague Med Rep 2018;119(4):165-169

Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Ampulla of Vater metastases from renal cell carcinoma are rare. The time between detection of the primary tumour and its metastasis may extend to years. Management should be aggressive, since the prognosis of renal cell carcinoma is unpredictable and curative surgery of metastases may extend patient survival and even lead to definite cure. Read More

World J Gastroenterol 2019 Feb;25(5):584-599

Department of Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.

Background: Claudin-7, one of the important components of cellular tight junctions, is currently considered to be expressed abnormally in colorectal inflammation and colorectal cancer. However, there is currently no effective animal model to study its specific mechanism. Therefore, we constructed three lines of knockout mice using the Cre/LoxP system. Read More

Clin Nucl Med 2019 Apr;44(4):e308-e310

From the Department of Radiology, Division of Nuclear Medicine, Mayo Clinic, Rochester, MN.

Carcinoid is a subtype of neuroendocrine tumor, a rare group of tumors that are known to express somatostatin receptor 2. Ga-DOTATATE is a somatostatin analog that is specific for somatostatin receptor 2 and therefore allows visualization of neuroendocrine tumors. We present 2 cases of primary multifocal small bowel carcinoid evaluated using Ga-DOTATATE PET/CT, along with contrast-enhanced CT corollary findings. Read More

Nat Commun 2019 02 13;10(1):723. Epub 2019 Feb 13.

Cancer Research UK Beatson Institute, Garscube Estate, Switchback Road, Glasgow, G61 1BD, UK.

Different thresholds of Wnt signalling are thought to drive stem cell maintenance, regeneration, differentiation and cancer. However, the principle that oncogenic Wnt signalling could be specifically targeted remains controversial. Here we examine the requirement of BCL9/9l, constituents of the Wnt-enhanceosome, for intestinal transformation following loss of the tumour suppressor APC. Read More

Am Surg 2018 Oct;84(10):1570-1574

Department of Surgery and †Division of Hematology and Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.

Small bowel neuroendocrine tumors (SBNETs) are often indolent, but occasionally, patients present with acute symptoms requiring emergent operative intervention. Our aim was to determine whether emergency surgery for SBNETs affects long-term outcomes. An institutional database was reviewed to identify patients with SBNET diagnosed between 1990 and 2015. Read More

Zhongguo Shi Yan Xue Ye Xue Za Zhi 2019 Feb;27(1):52-60

Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy in Tianjin, Tianjin's Clinical Research Center for Cancer，Tianjin 300060, China.E-mail:

Objective: To compare the prognostic value of different staging systems in primary intestinal diffuse large B cell lymphoma（PI-DLPCL）, and their correlation with clinicopathological characteristics，treatment and prognosis of PI-DLBCL.

Methods: A total of 68 patients with PI-DLBCL were recruited from January 2009 to July 2017. All the patients underwent staging by using TNM, Lugano, Blackledge and Musshoff system, survival curves for the PI-DLBCL patients were plotted using the Kaplan-Meier method and were judged by the log-rank test. Read More

BMC Gastroenterol 2019 Feb 4;19(1):21. Epub 2019 Feb 4.

Institute of Pathology, University of Cologne, Cologne, Germany.

Background: Carcinomas of the small bowel are rare tumors usually with dismal prognosis. Most recently, some potentially treatable molecular alterations were described. We emphasize the growing evidence of individualized treatment options in small bowel carcinoma. Read More

J Gastrointest Surg 2019 Apr 31;23(4):679-685. Epub 2019 Jan 31.

Division of Surgical Oncology, Harold C. Simmons Cancer Center, Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8548, USA.

Background: Meckel's diverticulum (MD) is an anomaly of the small intestine from which malignancy may arise. Among MD neoplasms, neuroendocrine tumors (NETs) are considered the most common. However, their metastatic potential and optimal surgical therapy remain ill-defined. Read More

Zhonghua Bing Li Xue Za Zhi 2019 Feb;48(2):92-97

Department of Pathology, Peking University People's Hospital, Beijing 100044, China.

To investigate the expression of immunomarkers CK7, CK20, CK17, CDX2, MUC1 and MUC2 in primary adenocarcinoma of the ampulla of Vater, to explore the role of these markers in the histopathologic subclassification of ampullary carcinoma; and to provide biologic basis for precision treatment of patients with different types of ampullary carcinoma. Forty-two cases of primary ampullary carcinoma were collected at Peking University People's Hospital, from 2012 to 2018 year. There were 22 males and 20 females. Read More

Indian J Cancer 2018 Jul-Sep;55(3):301-303

Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India.

Neurofibromas are benign neoplasms that are usually seen in hereditary disorders such as von Recklinghausen's disease [neurofibromatosis type 1 (NF1)]. The occurrence of isolated ileal neurofibroma in patients without the classic manifestations of NF1 or multiple endocrine neoplasia (MEN) syndromes is an extremely rare entity . We report one such case of isolated ileal neurofibroma in a 60 year old woman without any other stigmata of NF. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2438-2440

Dept. of Surgery, Yamato Takada Municipal Hospital.

We report the case of a 73-year-old woman with repeated recurrent small intestinal gastrointestinal stromal tumor(GIST) who was referred to our hospital for best supportive care. She underwent surgical resection 4 times and developed recurrent tumors that were resistant to imatinib. She complained of right lower abdominal pain caused by the recurrent tumor. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2399-2401

Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.

The case is a 73-year-old man who underwent esophagectomy and retrosternal gastric conduit reconstruction for esophageal cancer. Reoperation was performed because the oral side of the gastric tube developed necrosis on the 31st postoperative day. The necrotic parts of the gastric tube were resected, and a cervical esophageal stoma was created. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2024-2026

Dept. of Gastrointestinal Tract Surgery, Fukushima Medical University.

We report 2 cases of superficial non-ampullary duodenal tumor resected using laparoscopic endoscopic cooperative surgery( LECS). A man in his5 0's underwent screening esophagogastroduodenoscopy. Endoscopy revealed a 0-Ⅱc lesion at the anal side of the papilla of Vater that measured 5 mm. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):1964-1966

Dept of Surgery, Saiseikai Yokohamashi Nanbu Hospital.

A 74-year-old man was admitted to our hospital with multiple liver tumors detected by routine ultrasonography. Colonoscopy showed a type 2 tumor measuring approximately 25mm in diameter at the terminal ileum. The biopsy specimen showed neuroendocrine tumor(NET)G1. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2261-2263

Dept. of Surgery, Kanmon Medical Center.

A 69-year-old man was administered an ileus tube for ileus by ascending colon cancer. The next day, he underwent right hemicolectomy with D3 lymph node dissection for perforative peritonitis due to ascending colon cancer. The pathological diagnosis was A, type 2, muc>tub1, pT3, pN0. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2238-2240

Dept. of Surgery, Fujita Health University.

A 60-year-old male was admitted to our hospital on account of a duodenal submucosal tumor on the opposite side of Vater's papilla identified on a screening gastroduodenoscopy. The tumor was diagnosed as a duodenal gastrointestinal stromal tumor(GIST)due to positive c-kit and DOG1tests. Gastroduodenography and enhanced computed tomography showed a 50mm tumor widely invadingthe descendingportion of the duodenum close to the papilla of Vater and indicated the need for extended resection includingpancreaticoduodenectomy to achieve curation. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2223-2225

Dept. of Surgery, Fukuoka Tokushukai Hospital.

A 73 -year-old man was found to have a mesenteric tumor on abdominal ultrasonography and computed tomography (CT). Single-port laparoscopic surgery using an umbilical ZigZag incision was performed. Operative findings revealed that the tumor involved the mesentery. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2141-2143

Dept. of Surgery, The Nippon Dental University, School of Life Dentistry.

Undifferentiated pleomorphic sarcoma(UPS)of the small intestine is extremely rare and has a poor prognosis. We encountered a case of primary UPS of the ileum without metastatic lesions. The patient was a 44-year-old man who presented with the chief complaint of lower abdominal pain for 9 months. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2105-2107

Dept. of Surgery, Tohoku Rosai Hospital.

We report a resected case of cancer at the ileum of the blind loop. An 81-year-old male underwent an appendectomy for acute appendicitis and an ileotransverse colostomy for postoperative obstruction when he was 14 years old. He underwent radiation therapy for prostate cancer when he was 75 years old. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2102-2104

Dept. of Surgery, Tokamachi Hospital.

A 73-year-old male presented with melena and severe anemia. An esophagogastroduodenoscopy(EGD)and colonoscopy( CS)revealed no source of hemorrhage. Multiple small intestinal tumors were observed on abdominal ultrasound(US). Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2072-2074

Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.

A 42-year-old woman with complaints of fever and abdominal pain, was diagnosed to have perforative appendicitis, for which emergency surgery was performed. Marked thickening and edema around the cecum, ileum, and the mesentery was observed. Ileocecal resection was performed, as malignant disease could not be excluded. Read More

Medicine (Baltimore) 2019 Jan;98(4):e14235

Department of General Surgery.

Rationale: Extramedullary plasmacytomas (EMP) are tumors composed by a monoclonal population of plasma cells that arise in extraosseus tissues, occupying <5% of all plasma cell neoplasms. Gastrointestinal solitary extramedullary plasmacytoma is rare, just comprises about 5% of all EMPs. The most common site is small intestine. Read More

Neuroendocrinology 2019 Jan 23. Epub 2019 Jan 23.

The ARDEN NET Centre, European Neuroendocrine Tumour Society (ENETS) Centre of Excellence (CoE), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.

Background/aims: To evaluate the impact of lung metastases (LM) on overall survival (OS) in well-differentiated (WD) stage IV gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) patients along with developing surveillance strategies for thoracic imaging.

Methods: Thirty-four patients with LM, from 3 centres, were identified (22 small intestine/12 pancreatic; 17 grade 1/15 grade 2/2 of unknown grade). For comparison, we used 106 stage IV WD, grade 1 and 2 GEP-NEN patients with metastatic disease confined in the abdomen. Read More

Gastrointest Endosc 2019 02;89(2):355-356

Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam, Netherlands.

Medicine (Baltimore) 2019 Jan;98(2):e14115

Rationale: Mesenteric fibromatosis is a rare benign neoplasm with a tendency to spread and recur locally, without metastasis. It may present with a wide spectrum of clinical features; however, onset as a perforation is extremely rare.

Patient Concerns: The present patient was an 18-year-old female with a 10-hour history of increasing abdominal pain that arose suddenly with nausea and vomiting. Read More

Am Surg 2018 Dec;84(12):e524-e526

Cancer Immunol Immunother 2019 Mar 2;68(3):443-454. Epub 2019 Jan 2.

Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.

Adenocarcinoma of the ampulla of Vater (AOV) is classified into intestinal type (IT) and pancreatobiliary type (PB); however, the immunological properties of these subtypes remain to be characterized. Here, we evaluated the clinical implications of PD-L1 expression and CD8 T lymphocyte density in adenocarcinomas of the AOV and their potential association with Yes-associated protein (YAP). We analyzed 123 adenocarcinoma-of-the-AOV patients who underwent surgical resection, and tumors were classified into IT or PB type. Read More

BMC Endocr Disord 2018 Dec 27;18(1):98. Epub 2018 Dec 27.

Endocrine Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Careggi University Hospital, Florence, Italy.

Background: Insulinoma is a rare tumour representing 1-2% of all pancreatic neoplasms and it is malignant in only 10% of cases. Locoregional invasion or metastases define malignancy, whereas the dimension (> 2 cm), CK19 status, the tumor staging and grading (Ki67 > 2%), and the age of onset (> 50 years) can be considered elements of suspect.

Case Presentation: We describe the case of a 68-year-old man presenting symptoms compatible with hypoglycemia. Read More

World J Surg Oncol 2018 Dec 21;16(1):238. Epub 2018 Dec 21.

Department of Gastrointestinal Surgery, Department of General Surgery, First Affiliated Hospital of Anhui Medical University, 218 JiXi Avenue, Hefei, 230022, Anhui, China.

Objective: To evaluate the intraoperative and short-term postoperative outcomes of a novel robotic intracorporeal π-shaped esophagojejunostomy (EJS) after D2 total gastrectomy (TG) using the Da Vinci robotic surgical system for intracorporeal anastomosis after TG.

Background: Intracorporeal π-shaped EJS, using a linear stapler, was recently reported for laparoscopic total gastrectomy in patients with gastric cancer. However, robotic intracorporeal π-shaped EJS using a linear stapler has not been reported. Read More

Medicine (Baltimore) 2018 Dec;97(51):e13648

Department of Gastric and Colorectal Surgery, The First Affiliated Hospital of Jilin University, Changchun, Jilin, China.

Rationale: Pleomorphic rhabdomyosarcoma (PRMS) is a rare soft tissue malignancy which is frequently misdiagnosed and associated with metastasis to the lungs, lymph nodes, and bone marrow. Case studies are needed to improve the awareness of the disease and our understanding of it.

Patient Concerns: In this study, we present a case of a 36-year-old man with a lesion on the right back shoulder. Read More

BMJ Case Rep 2018 Dec 13;11(1). Epub 2018 Dec 13.

Department of Oncology, Mount Sinai Health System, New York, New York, USA.

Posttransplant lymphoproliferative disorder (PTLD) is a recognised complication of solid and haematopoietic stem cell transplant. It consists of a heterogeneous group of lymphoid neoplasms that arises secondary to post-transplant immunosuppression. Although there is no definite standard of care for the optimal treatment for PTLD, rituximab, a monoclonal antibody, with and/or without chemotherapy (usually CHOP=cytoxan, doxorubicin, vincristine, prednisone) has become a routine part of the treatment of any CD20 (+) PTLD, with response rates similar to chemotherapy with decreased toxicity. Read More

BMJ Case Rep 2018 Dec 13;11(1). Epub 2018 Dec 13.

Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Peutz-Jeghers syndrome (PJS) is an autosomal dominant cancer-predisposing condition characterised by intestinal hamartomatous polyps and distinct melanin depositions in skin and mucosa. Small intestinal cancer in patients with PJS usually presents by the third decade. A 7-year-old-PJS boy presented with recurrent episodes of colicky abdominal pain and melena requiring repeated blood transfusions. Read More